Clincal Features of Iris Melanoma in 600 Cases

Abstract

Purpose: : To analyze the clinical features and outcomes of iris melanoma from a single ocular oncology center

Methods: : Retrospective chart review

Results: : Mean patient age at presentation was 52 years, and 56% were female and 44% were male. The predominant eye color was blue in 394 patients (66%). At presentation, mean basal tumor diameter was 4.8 millimeters (mm) and mean tumor thickness was 3.5 mm. Other features included sentinel vessels in 31%, intrinsic vessels in 27%, ectropion irides in 23%, corectopia in 22%, secondary cataract in 17% iris feeder vessels in 10%, and related glaucoma in 33%. In those tumors that were excised (n=397), the predominant cell type was spindle melanoma in 55%, mixed melanoma in 42%, and epithelioid melanoma in 3%. After a mean follow up of 4 years, metastasis developed in 35 cases (6%), affecting mostly the liver (n=30, 86%). The most common treatments were excisional biopsy in 267 (45%), enucleation in 170 (28%), and plaque radiotherapy in 163 (23%).

Conclusions: : Of 600 consecutive cases of iris melanoma, the most common clinical features at presentation included sentinel (31%) and intrinsic (27%) vessels and related glaucoma in 33%. Over 4 years mean follow up, 6% developed metastatic disease.

Keywords: iris • melanoma • tumors